Heuristic Model Linking Contextual Processes to Self-Management in African American Adults With Type 2 Diabetes

PURPOSE: This article examines the influence of various environmental factors on the diabetes self-care practices of African American adults with type 2 diabetes. METHODS: A heuristic model was developed that considers how community barriers and supports, availability and use of insurance, diabetes education, medical provider-patient relationships, extended family processes, and psychological functioning may indirectly affect metabolic control through the patient's ability to regulate diabetes. RESULTS: The proposed model offers a framework to demonstrate the complexity of diabetes management that may be unique to the African American experience. CONCLUSIONS: A comprehensive view of the environmental context will lead to new and more effective approaches in diabetes education and counseling for African American adults with type 2 diabetes.